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ICP Waiver Rendering Provider Enrollment and Profile Maintenance Packet Version 8.0, June 2020Page 1 of 11| Overview ICP Waiver Rendering Provider Enrollment and Profile Maintenance Packetin.gov/medicaid/providersBefore
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ihcp-waiver-rendering-provider-enrollment-and-maintenance is a form used to enroll and maintain providers in the IHCP Waiver program.
Providers who wish to participate in the IHCP Waiver program are required to file this form.
The form can be filled out online or submitted via mail with all required information and documentation.
The purpose is to ensure that providers meet the necessary requirements to participate in the IHCP Waiver program.
Providers must report their personal information, qualifications, certifications, and any other relevant details.
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